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2015—2022年青海省四大类慢性病死亡特征及减寿分析：基于国家级死因监测点数据

Mortality characteristics and life loss status for four major types of chronic diseases in Qinghai province, China (2015–2022): based on the data from national-level mortality surveillance sites

    摘要
  • 摘要:
    目的 分析2015—2022年青海省恶性肿瘤、心脑血管疾病、呼吸系统疾病和糖尿病四大类慢性病的死亡特征及其寿命损失情况和变化趋势，为该地区四大类慢性病的预防控制提供参考依据。
    方法 收集2015—2022年青海省死因监测系统中10个国家级死因监测点的77 582例死亡个案数据，分析四大类慢性病的粗死亡率、标化死亡率、年龄别死亡率、可避免的潜在减寿年数（PYLL）、可避免的减寿率（PYLLR）和可避免的平均寿命损失年（AYLL）等指标，并采用平均年度变化百分比（AAPC）描述其变化趋势。
    结果 2015—2022年青海省四大类慢性病的粗死亡率、可预防粗死亡率和可治疗粗死亡率均呈上升趋势（AAPC=4.363%、2.047%和3.011%，均P<0.05）；但标化死亡率、可预防标化死亡率和可治疗标化死亡率变化趋势差异均无统计学意义（均P>0.05）。不同特征人群中，2015—2022年四大类慢性病男性、城市和农村人群的粗死亡率、可预防粗死亡率和可治疗粗死亡率，女性和牧区人群的粗死亡率以及牧区人群的可治疗粗死亡率均呈上升趋势（均P<0.05）。城市人群可治疗标化死亡率变化呈上升趋势（AAPC=2.853%，P=0.002）。2015—2022年青海省四大类慢性病死亡率均随年龄的增长呈上升趋势（均P<0.001）；男性人群可避免的年龄别死亡率始终高于女性人群（均P<0.05）；各年龄段城市人群可避免死亡率均最低。死亡减寿分析结果显示，2015—2022年青海省四大类慢性病可治疗的PYLL和可治疗的PYLLR均呈上升趋势，可预防的AYLL和可治疗的AYLL均呈下降趋势（均P<0.05）；不同特征人群中，2015—2022年青海省四大类慢性病男性人群PYLL以及城市人群PYLL、可预防的PYLL、可治疗的PYLL和可治疗的PYLLR均呈上升趋势；男性人群AYLL和可预防的AYLL、女性人群AYLL和可治疗的AYLL、农村人群PYLL以及农村和牧区人群AYLL、可预防的AYLL、可治疗的AYLL均呈下降趋势（均P<0.05）。
    结论 2015—2022年青海省四大类慢性病死亡率呈上升趋势，随年龄增长上升趋势明显；农村和牧区在降低慢性病人群平均寿命损失上成效突出，城市的寿命损失负担加重，降低人群可治疗和可预防的死亡是今后慢性病防控的重点目标。

     

    Abstract:
    Objective To analyze the mortality characteristics, life loss status, and temporal trends of four major types of chronic diseases (malignant tumors, cardiovascular and cerebrovascular diseases, chronic respiratory diseases, and diabetes mellitus) in Qinghai province from 2015 to 2022, thus providing a scientific basis for the prevention and control of these diseases in the region.
    Methods A total of 77 582 death case records were collected from 10 national-level mortality surveillance sites in the Mortality Surveillance System of Qinghai Province during 2015–2022. Indicators including crude mortality rate (CMR), standardized mortality rate (SMR), age-specific mortality rate (ASMR), avoidable potential years of life lost (PYLL), avoidable potential years of life lost rate (PYLLR), and avoidable average years of life lost (AYLL) of the four major types of chronic diseases were analyzed. The average annual percent change (AAPC) was used to describe their temporal trends.
    Results From 2015 to 2022 in Qinghai province, the CMRs, preventable crude mortality rates, and treatable crude mortality rates of the four major types of chronic diseases all showed an increasing trend (AAPC = 4.363%, 2.047%, and 3.011%, respectively; all P < 0.05), while no statistically significant differences were observed in the trends of SMR, preventable standardized mortality rate, and treatable standardized mortality rate (all P > 0.05). From 2015 to 2022, increases were observed in the CMR, preventable crude mortality rate, and treatable crude mortality rate in males, urban populations, and rural populations, the CMR in females and pastoral populations, and the treatable crude mortality rate in pastoral populations (all P < 0.05). Only the treatable standardized mortality rate of urban populations showed an upward trend (AAPC = 2.853%, P = 0.002). The mortality rates of the four major types of chronic diseases in Qinghai province increased with the increase in age (all P < 0.001), and the avoidable age-specific mortality rate in males was consistently higher than that in females (all P < 0.05). The avoidable mortality rate was the lowest in urban populations across all age groups. The results of the life loss analysis showed that the treatable PYLL and treatable PYLLR of the four major types of chronic diseases in Qinghai province from 2015 to 2022 increased, while the preventable AYLL and treatable AYLL decreased (all P < 0.05). From 2015 to 2022, the PYLL in males, as well as the PYLL, preventable PYLL, treatable PYLL, and treatable PYLLR in urban populations increased; the AYLL and preventable AYLL in males, AYLL and treatable AYLL in females, PYLL in rural populations, and AYLL, preventable AYLL, and treatable AYLL in rural and pastoral populations decreased (all P < 0.05).
    Conclusions From 2015 to 2022, the mortality rates of the four major types of chronic diseases in Qinghai province presented an upward trend, and this upward trend became more pronounced with the increase in age. The burden of life loss in urban areas was aggravated, whereas rural and pastoral areas achieved remarkable effects in reducing the average life loss of the population with chronic diseases. Reducing treatable and preventable deaths of the population shall serve as the goal for future prevention and control work

     

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